— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師準備皮下注射肝素，下列哪些是正確的操作方式？（選所有適合的）
A nurse is preparing to administer heparin subcutaneously. Which actions are appropriate for the nurse to perform? (Select all that apply.)
- AInject the medication into the abdominal fat✓ 正解將藥物注入腹部脂肪層
- BAspirate the syringe before injecting注射前回抽注射器
- CMassage the injection site after removal拔針後按摩注射部位
- DRotate injection sites to prevent tissue damage✓ 正解輪替注射部位以預防組織損傷
- EAvoid injecting within 2 inches of the umbilicus✓ 正解避免在距離臍部兩吋範圍內注射
— Explanation · 中文詳解 —
肝素注射需選擇腹部皮下脂肪層，且應避開肚臍周圍 2 英吋以防出血瘀斑。切記不可按摩注射部位，以免造成皮下微血管破裂與血腫；亦不需回抽（Aspiration），因現代臨床證據顯示回抽會增加出血風險，且此部位無大血管。
Heparin injections should be administered into the subcutaneous fat layer of the abdomen, avoiding a 2-inch radius around the umbilicus to prevent bleeding and bruising. The injection site must not be massaged afterwards, as this can rupture subcutaneous capillaries and cause hematoma. Aspiration is also not required, as current clinical evidence shows aspiration increases bleeding risk, and there are no large vessels in this site.
✦ 台美臨床差異
台灣與美國臨床指引一致，皆強烈建議取消回抽與按摩動作，以減少皮膚瘀斑。